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Television's depictions of psychologists and other mental health professionals in comedy and drama distort both their own emotional adjustment and their relationships with their clients. From Bob Newhart in the 1970s to the current Dr. Judith Evans of "Awake," psychotherapists on television say and do things that range from mildly unprofessional to overtly disturbing. Yet these characters continue to engage our attention and their shows often become runaway hits. Why is the public so fascinated with the misadventures of psychologists, and when will Hollywood learn to get it right?
It started with the "Bob Newhart Show" in 1972 when the dry-witted comedian became the first TV psychologist to star in a series. His insecurities, gaffes, and generally neurotic tendencies often put him in situations that made him as much the patient as the therapist. This hit show ran for 6 years and for the next 6 years, you could only find TV psychologists in that show's reruns.
Then came "Cheers", in 1982, which introduced the legendary Frasier Crane, played by multiple Emmy winner Kelsey Grammer. Crane was technically a psychiatrist but he blurred the boundaries between psychiatry and psychology with his focus on psychoanalysis as his primary theorecital orientation. His wife, Lilith Sternin-Crane (played by Bebe Neuwerth), talked mostly about her experimental and behavioral research. Their ill-fated relationship was to end in a bitter divorce, and their shared misery also became the focus of much of the show's humor. Crane seemed to spend much of his professional life at the bar, and in fact seemed to use it for his own therapeutic purposes. He also suffered from alcohol dependence, which he openly admitted: "All right, let's review. Last night, I got knee walking drunk and now I am back this bar a mere seven and a half hours later, hung over... well, it's official. I have a problem."
Frasier Crane next appeared as the title character of his own smash hit, "Frasier," which aired from 1993-2004. Joined by his younger brother, Niles Crane (played by David Hyde Pierce), the two often bandied about diagnoses, treatments, and quotes from their favorite psychoanalysts, as in this exchange:
Niles: I had an abysmal day. Remember the ad I placed?
Frasier: Oh yes - 'Dr. Niles Crane, Jung specialist'..
Niles: Yes. Well, they've made a tiny little typo. See if you can find it.
Frasier: (reading)'Dr. Niles Crane... Hung specialist'... Oh, my!
Niles: The rest they got perfectly... 'Servicing individuals, couples, groups. Satisfaction guaranteed... Tell me where it hurts!'
Frasier: Well... any calls?
Niles: It's a telethon, Frasier.
Niles and Frasier wrestled out their sibling rivalry throughout the entire 11 years of this wildly popular show. Their vying for superiority, constant one-upsmanship, and shared distress over their inability to maintain relationships was the grist for the mill for most of the show's run. Frasier's main source of income was his job as a radio therapist whose advice itself became a mockery of the type of treatment a true mental health professional would provide.
Psychologists have now largely stepped out of comedic roles, though the current USA Network show "Psych," which features a "psychic" crime consultant, is also a comedy. Along similar lines, "The Mentalist" stars an independent consultant to a California police department with sharp, supposedly telepathic, observational powers.
Increasingly, psychologists are being portrayed on crime dramas as profilers. Two of the most prominent are Dr. Spencer Reed ("Criminal Minds") and Dr. George Huang played by B.D. Wong ("Law and Order SVU"). In as short a span as 30 seconds, they cut through to the complex mental state of criminals and victims, ultimately leading agents and police officers to garner suspects and ultimately convictions.
These psycholgists in their dramatic personifications seem to play valued roles. However, they also have very visible cracks in their armor. Spencer Reed has a murky psychological past as evidenced by his mother (played by Jane Lynch) who is hospitalized with chronic schizophrenia. Occasionally, Reed has flashbacks to a traumatic childhood and when confronted with certain criminals, seems to go off the rails.
Providing therapy is the third category of television psychologists. Perhaps the most well-known of these was Dr. Jennifer Melfi, of the HBO blockbuster, "The Sopranos." Played with passion by Lorraine Bracco, Dr. Melfi was also apparently a psychiatrist (as she dispensed medications). However, like the Crane brothers, her main focus of treatment was psychoanalytic psychotherapy. Tormented by the mob secrets that Tony Soprano regularly shared with her, she eventually struggled with her attraction toward Tony. She appropriately sought help with her "counter-transference" from her supervisor, but in stunning breaches of confidentiality, revealed some of what happened in therapy with Tony to others outside that relationship.
Therapists also appear in reality or reality-type shows, including "In Treatment," "Intervention," and "Hoarders." Then there is Dr. Phil, who no longer practices psychology, though this fact may be lost to viewers. We can trace Dr. Phil's origins to Dr. Joyce Brothers, who in the late 1950s and 1960s used her television show to provide advice that mainly took the form of common-sense feel-good homilies that contrasts with Dr. Phil's confrontational attacks on his "clients."
Returning to fictional mental health professionals, the most recent entries are Cherry Jones and B.D. Wong who play psychiatrists- one real, and one imaginary- in the NBC drama "Awake." Although the show is too new to allow for definite conclusions to be made about its portrayal of mental health professionals, it seems to be off to a bad start. For example, in the second episode, Dr. Evans (Jones's character) summarizes the problems of the shows main character (Detective Britten) in an this ominous pronouncement: "Your condition is the result of a deeply fractured psyche." What on earth is a "deeply fractured psyche," I'd like to know?
You may be wondering by this point what the effect of all this on the public image of psychologists and other mental health professionals. After all, bringing psychology out into the media should be a good thing. At least we're talking openly about mental health problems instead of trying to keep them hidden. Unfortunately, the effect is less than sanguine. Viewers may get a good laugh out of watching an emotionally crippled therapist. However, they're not then going to be particularly likely to pick up the phone and call their nearest professionals after seeing how prone they are to meltdowns. After all, why would you seek therapy from a professional who you imagine is in even worse shape than you?
Not only might the public fear being treated by a mentally unstable therapist, but many people would (quite realistically) worry about the possibility that their therapist might violate professional boundaries. Television therapists regularly commit ethical violations. They have multiple relationships with their clients, the worst of which occurs when they become romantically involved with them. They talk about cases with their own family members, provide treatment outside their range of expertise, and provided outdated if not hackneyed versions of therapeutic interventions (the "fractured psyche").
That the television portrayal of psychologists has backfired is evident from a 2008 study of college undergraduates conducted by Iowa State researchers David Vogel and colleagues examining the relationship between psychology TV viewing and attitudes toward seeking therapy. The more comedy and drama programs these students watched, the more negative their attitudes. They expected little benefit from consulting a therapist, and were less likely to seek mental health services. Moreover, many television portrayals of clients did so in a stigmatized manner, further contributing to the negative attitudes that college students had toward therapy.
All mental health professionals are bound by strict ethical codes that prohibit exactly the behavior we see on television. In the case of psychology, these ethical codes include not only specifications about multiple relationships but also set the bounds of ethical behavior in police and military interrogations. The APA codes requires that clients be protected by confidentiality and be allowed to provide informed consent. The code prohibits false advertising and public statements: "Psychologists do not knowingly make public statements that are false, deceptive, or fraudulent concerning their research, practice, or other work activities or those of persons or organizations with which they are affiliated." Yet, television rarely if ever alludes to these and the many other codes of professional conduct in the mental health field.
Studies of actual psychologists show that the vast majority adhere strictly to ethical guidelines. Research by Lamb et al conducted in 2004 showed that even when they find themselves sexually attracted to a client, psychologists do not follow through on their interest due to their personal ethics, values, and morals. Even though it is admissible to have a sexual relationship with a former client (after a period of years) the therapists in this study did not do so. They stated that they wished to avoid dual relationships and/or did not want to take advantage of the unequal power dynamics between themselves and clients. Relatively few respondents mentioned that they stayed away from these unethical situations due to fear of being sued or sanctioned by the profession.
If you're an avid television fan of psychologically-oriented shows, it's important for you to become a discerning viewer. Unless you watched the "Discovering Psychology" series and other TV specials featuring the legendary "other Dr. Phil," i.e. Stanford University's Philip Zimbardo, you've not gotten a true taste of what happens in a therapist's office. With the strict ethical requirements, licensing board statutes, and other protections of your rights, you needn't fear that your therapist will exploit or mistreat you. Psychologists themselves can certainly have emotional issues, but with these guidelines in place, you can feel confident that these issues will not compromise your treatment. Television shows and characters are there to entertain you, not to offer true therapy.
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Copyright Susan Krauss Whitbourne 2012
References:
Vogel, D. L., Gentile, D. A., & Kaplan, S. A. (2008). The influence of television on willingness to seek therapy. Journal Of Clinical Psychology, 64(3), 276-295. doi:10.1002/jclp.20446
Lamb, D. H., Catanzaro, S. J., & Moorman, A. S. (2004). A Preliminary Look at How Psychologists Identify, Evaluate, and Proceed When Faced With Possible Multiple Relationship Dilemmas.Professional Psychology: Research And Practice, 35(3), 248-254. doi:10.1037/0735-7028.35.3.248
See also these related resources:
Division 46 APA (Media Psychology)
Kendra Cherry's "About Psychology" writeup of Vogel et al.'s research.
American Psychological Association Grad Psych writeup of TV's portrayal of psychologists.
